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sooner Offline OP
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It seems that my husbands extreme fatigue and other symptoms may be related to kidney compromise from the Cisplatin. They are giving him extra fluids daily and drugs to try to bring down his numbers and sort out if it his kidneys are actually compromised or if it is dehydration but they have scheduled an appointment for us with the oncologist to evaluate the third dose of Cisplatin. I would like to know if any of you have had to forgo the last dose? We are both concerned about the impact on survival if the last dose is not administered. However, we also know that kidney protection is critical. We read conflicting things about the importance of the 3rd dose. His nutrition seems back on track.


Wife to DP. DX SCC BOT 1/31/17
First treatment 2/27/2017 Cisplatin 3 times and IMRT
Last treatment 4/18/2017
Clear PET 7/13/2017
PEG removed 8/4/2017
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It is common when getting the 3 big bag method of chemo the third dose either gets cut down in quantity or omitted. My second dose was cut in half and the third one completely cancelled. I didnt mind at all, I was so sick I couldnt have tolerated any more chemo. From what I understand the first dose helps considerably with the second and third doses helping much less than the first one. My doc explained that the third dose only helps a very little bit so its not a big deal to skip it. I suggest talking in more detail with your husbands doctor about what impact it could have on his chances of completely eliminating the cancer with only his current treatment. I would also ask if he should have another chemo for the third dose.

Cisplatin does have some side effects. Hearing loss is the most common problem Ive seen patients have with cisplatin. Then the patient is usually switched over to carboplatin. I think Paul had some pretty big kidney problems. Im not sure if his problems were due to cisplatin or another kind of chemo.

Im very glad to hear your husband is doing well with his intake. Great job!!!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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My husband had to skip his third dose of Cisplatin because he developed blood clots in both legs. He was placed on blood thinners but he couldn't start this medication because the creatinine was too low. We had to wait until the count had gone back up a bit. The MO told us that it wasn't the chemo that caused the blood clots but the fact that he had cancer. She assured us that there was no point in getting the third dose. John was in really bad shape at that point due to the chemo so it was actually a relief not to have to go for the third dose.


Gloria
She stood in the storm, and when the wind did not blow her way, she adjusted her sails... Elizabeth Edwards

Wife to John,dx 10/2012, BOT, HPV+, T3N2MO, RAD 70 gy,Cisplatinx2 , PEG in Dec 6, 2012, dx dvt in both legs after second chemo session, Apr 03/13 NED, July 2013 met to lungs, Phase 1 immunotherapy trial Jan 18/14 to July/14. Taxol/carboplatin July/14. Esophagus re-opened Oct 14. PEG out April 8, 2015. Phase 2 trial of Selinexor April to July 2015. At peace Jan 15, 2016.
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My oncologist nixed the 3 dose option because I already had significant hearing loss in my right ear from years of hunting. She went with the smaller doses once a week for eight weeks concurrent with the radiation. Towards the end I got pretty sick and was running a fever. They ended up canceling the last three weeks of Chemo therapy. I was upset but the doctor said it was no big deal. She said the outcome wouldn't change as the primary treatment was the radiation. In the end she was right.

I wouldn't worry too much about it. Glad to hear the nutrition problem is under control. Keep up with the liquids too and he should continue to feel better. You guys are in the home stretch! Stay positive 🤠


Edward, 64 yrs
7/21/2016 Dx BOT stage 4 w additional tumors neck & left lymph node
8/15/2016 began Tmt EBT w Cesplatin 1x week for 8 wks.
Feeding tube and port.
10/17/2016 finished treatment. CT still shows tissue. Dr. Says 60% chance it is scar tissue.
01/13/2016 PET Scan shows no sign of cancer.
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Although it's ideal to finish treatment as planned, it's not uncommon for doctors to reduce the dosage, infusion rate, change drugs delay or stop it completely when it comes to Chemo, which mainly acts as a radiosensitizer to make radiation work better, and stays in the body for a specified period depending the type of chemo. Chemo by itself does not cure this cancer.

I've had to stop all my treatment completely, and any future treatments, for an unknown duration, due to the side effects from High Dose Induction Chemo (IC); Cisplatin, Taxotere, and 5-FU in 2009. One of the problems with IC is your body's response is not given enough time, and not really gauged past a few days, when all the chemo is given, and can't be reduced, changed or taken back at that point.

As a result, I suffered multiple side effects, an understatement, many relating to the Sepsis and Septic Shock, which included Kidney Failure. The kidneys can have accute toxicities, and recover, once the cause is treated or taken away, but some accute toxicities if ongoing or bad enough, can cause chronic kidney failure, and may not fully recover to normal levels sometimes, but may become stable enough where it's manageable, and no other treatment is necessary, other than scheduled blood testing. That's where I'm at now, but a few times I was almost placed on dialysis, but I have a good nephrologist who has kept me off.

A number of conditions can compromise the kidneys, including chemo, dehydration, kidneys stones, infection, etc, and hopefully they can identify the cause, correct, and monitor the kidneys with no further problems.

Good luck


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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sooner Offline OP
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His lab numbers were much improved today after lots of IV fluids, nutrition and hydration. So, we will see what the decision is one week from today. Thanks for all of your support. In the end it is out of our control once we do all that we can to have him as healthy as possible.


Wife to DP. DX SCC BOT 1/31/17
First treatment 2/27/2017 Cisplatin 3 times and IMRT
Last treatment 4/18/2017
Clear PET 7/13/2017
PEG removed 8/4/2017
Joined: Feb 2017
Posts: 67
Likes: 1
sooner Offline OP
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Joined: Feb 2017
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In case this happens to anyone else....the final decision even with labs that rebounded and looked pretty good before the third round of chemo and maintaining his weight, was to reduce the last round of chemo by half. The feeling was that his kidney function might not rebound after the third full dose. So we are happy with this decision. We have worked so hard to keep his hydration and nutrition on track. It's a daily challenge for a variety of reasons. He has had IV fluid support as well.


Wife to DP. DX SCC BOT 1/31/17
First treatment 2/27/2017 Cisplatin 3 times and IMRT
Last treatment 4/18/2017
Clear PET 7/13/2017
PEG removed 8/4/2017

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